This article focuses on the sacred ground of confidentiality, but what
about the use of physical and psychological torture--whether doctors
are involved and compromised or not?

Health Professionals Involved in Guantánamo Interrogations
by Steven Reinberg
HealthDay News

Wednesday 22 June 2005

Doctors compromised medical ethics, article claims.

   Acting in contradiction to medical ethics, physicians,
psychiatrists and psychologists have played an active role in the
interrogations of foreign detainees in the U.S. prison at Guantánamo
Bay, Cuba, new research claims.

   The revelations, which will appear in the July 7 issue of the New
England Journal of Medicine, were released online Wednesday night.

   According to the report, prisoners do not have any medical
confidentiality, which allows medical personnel to use what they have
learned to aid in interrogations.

   "Contrary to what the Bush administration has said, the rule is no
confidentiality for the detainees at Guantánamo," said study co-author
Dr. M. Gregg Bloche, a law professor at Georgetown University in
Washington, D.C. "Assistant Secretary of Defense for Health Affairs
William Winkenwerder said as recently as last week that confidentiality
protections and exceptions were analogous to those enjoyed by American
citizens."

   However, there is a standing order that has not previously been
reported, he said. Dated August 2002, the order says that not only is
there no medical confidentiality, but health-care providers must report
any information of potential interest to medical and non-medical
personnel at Guantánamo, he added.

   "In addition, in a systematic fashion, medical information was
employed by behavioral science consultants to support the interrogation
process," Bloche said. "These behavioral scientists, typically a
psychiatrist and psychologist, were assigned to a Behavioral Science
Consultation Team."

   These consultants had access to medical records and used them to
develop profiles that could be used to help interrogators, Bloche said.

   "The American people have not been leveled with," Bloche said. "We
need to know a lot more, including the strategies for crafting
interrogation tactics. Also, it's important that we separate the
process of clinical caregiving from the process of interrogation."

   To make medical information available for interrogation makes every
health-care provider part of a network of surveillance, Bloche said.
"That's going way too far. Clinical information should not be made
available to those planning an interrogation," he added.

   Bloche believes there is a narrow role for psychologists in
developing lawful interrogation strategies. "But given what's been
widely reported about the kind of tactics used at Guantanamo, it's
plain that the tactics went too far. And we have learned that the
Behavioral Science Consultation Teams were pervasively involved."

   Not only is there probable cause to suspect that the members of the
Behavioral Science Consultation Teams were complicit, Bloche said, "but
the lack of confidentially makes clinical caregivers participants in
this pervasive process."

   "We need a fuller, thorough and independent inquiry for the abuses
at Guantánamo," Bloche said. "As a part of that inquiry, there should
be an inquest into the ways in which abuse of interrogation practices
were devised."

   Although the Bush administration has said the Geneva Conventions
didn't apply to the prisoners in Guantánamo, Bloche contended, it also
said prisoners would be treated in accordance with those conventions.

   "Plainly, the administration has violated that," he said. "It's
clear that the lack of protection of medical confidentiality violated
Geneva rules."

   On Tuesday, the White House rejected the creation of an independent
commission to investigate allegations of detainee abuse by military
personnel at Guantánamo and elsewhere, according to a Washington Post
report. White House spokesman Scott McClellan said that the Pentagon
has launched 10 major investigations into abuse allegations, and that
the Defense Department would continue to investigate any new
allegations.

   In addition, the Pentagon last week issued new guidelines for
medical personnel that says their only involvement in treating
detainees is to "evaluate, protect or improve their physical and mental
health." According to an Associated Press report, the guidelines,
issued by Assistant Defense Secretary Winkenwerder, also said that
doctors and experts - such as the psychologists, profilers and forensic
pathologists who advise interrogators - are not to be involved in
treating detainees, but must uphold the principles of humane treatment.

   Speaking to reporters June 16, Winkenwerder could not say whether
the guidelines mark any change from existing policy, AP reported. Their
purpose is to prevent any abuse in the future, he said.

   Reaction to the journal article was swift.

   "It's great that somebody is talking about this," said Jumana Musa,
advocacy director for domestic and international justice at Amnesty
International. "It's been out there for a long time, but it gets lost
in the mix because people don't realize the grievous nature of it."

   Musa thinks that it's unfair that prisoners are supposed to get
medical care from doctors who can turn around and give the information
to the military commission, where it can be used to convict them.
"Effectively, that means there is no medical care available to them,"
Musa said.

   Having medical personnel in interrogations also raises questions,
Musa added: "What's being done in interrogations if you need to have
medical people standing by? What does that mean, ethically, to the
medical profession?"

   There are questions raised by this that go beyond whether prisoners
have access to medical care, Musa said. "The lack of confidentially may
prevent someone from seeking medical care if they know it's going to be
used against them in interrogation," she added. "Your job as a doctor
is to treat and to heal, not to facilitate interrogations."

   More Information

   The American Medical Association can tell you more about medical
ethics at www.ama-assn.org.